Dr. Pathik Parikh Hepatologist and Liver Transplant Physician

  Liver as you all know it, is not only the second largest organ of the body after skin, but also a major organ for metabolizing. Whatever we eat goes to liver before reaching anywhere else in the body. The liver stores the excess energy as fat and condensed glucose known as glycogen. So whenever we eat excessively, the energy is stored in liver as fat. If we continue to do so for months and years together, the liver starts accumulating fat and enlarges in size. A point comes when liver no longer can take it and starts undergoing destruction. What is Fatty Liver? Whenever the fat accumulation in liver crosses 5% of liver weight it is known as fatty liver. Though in last century alcohol was believed to be the major cause of fatty liver, the diet and lifestyle is rapidly becoming the major cause of fatty liver now. The disease is known as non alcoholic fatty liver disease or NAFLD. Once it starts destroying liver it is called as steatohepatitis or NASH. Who is likely to have it? All ...

  Liver is the largest internal organ of our body and has more than 500 functions. Considering the significance of liver, we expect it to cause symptoms even with minimal injury. However, liver is quite resilient with tremendous regenerating capacity and hence, symptoms do not appear till very late. Even with ongoing liver damage, liver tries to cope up by not only enhancing the function of remaining liver but also be growth of the liver tissue. Based on the acuity of liver damage we can get symptoms. When the liver suffers from acute insult, there are symptoms seen frequently (as we see with routine viral hepatitis). However, if it is chronic or gradual long standing damage, there would be no symptoms. Symptoms only develop in such situation when liver failure begins. We divide symptoms and signs of liver damage in three subgroups   A)  Acute Hepatitis – The symptoms are known to every one of us. The most common cause is viral hepatitis A or E. Patients initially have lo...

Successful Management of Anti Tuberculosis Therapy induced liver failure by Liver Team 50 year old female during routine follow up was diagnosed to have mild pericardial effusion. She was started empirically on 4 drugs anti tuberculosis therapy (ATT). She tolerated the therapy well and on completion of intensive phase her pericardial effusion disappeared. She was maintained on isoniazid, rifampicin and ethambutol therapy. 4 months after starting ATT, she noticed jaundice and consulted her physician who stopped ATT and started her on Ursodeoxycholic acid. However, her jaundice worsened and that is when she presented to Zydus Hospitals. At the first visit she had full blown liver failure. Her reports showed a bilirubin of 14 mg/dl, AST 157 IU/ml, ALT 90 IU/ml, Albumin 2.9 mg/dl and a International Normalized Ratio (PT-INR) of 7.1. Her ultrasound showed mild ascites and hypo echoic liver. She had over encephalopathy with flaps on examination. She was counseled about the need for l...

All patients who are  suffering from liver disease  and need a transplant are currently in dilemma on when and how the transplant would proceed. Even doctors are in dilemma on whether they should divert the healthcare staff and infrastructure to transplant when we have a great pandemic going on. To answer these queries, the American, European, Asian and Indian societies have drawn out guidelines for doctors to help in decision making. Should we as healthcare providers decide on who is more in need of limited resources, i.e., COVID-19 patients versus patients in  urgent need of liver transplantation?  It is impossible to weigh the value of the life of a patient with COVID-19 against that of a patient in need of life-saving liver transplantation. We should not compound the pandemic by risking the lives of patients in need of liver transplantation and our goal should be to ensure that an ICU bed is available for every patient who requires one. All centers offeri...

What do you mean by cirrhosis of liver? In medical terms cirrhosis is diffuse irreversible damage to liver parenchyma. In the current era, it is irreversible. That means that the damage to the liver has crossed the point of no return. Although, you can remain stable with cirrhosis, you cannot cure or reverse cirrhosis of liver.  Under normal circumstances, liver is smooth and soft to touch. In cirrhosis your liver becomes hard and irregular and rough. In simple terms, it means, your liver is damaged. How does cirrhosis affect your body? Liver performs more than 500 functions. So when you develop cirrhosis, these functions start decreasing. Some of these functions include cleaning of toxic byproducts of your body, metabolizing all the food that you eat, storing important vitamins and even forming proteins necessary for life. Besides, all the blood from your tummy (including from your intestines), drain through the liver into the heart. In cirrhosis this draina...

Covid-19 is a disease caused by a novel type of coronavirus now termed as SARS-CoV-2. The virus originated from Wuhan, #China and has now spread throughout the world now responsible for more than 50,000 deaths worldwide. The disease is primarily responsible for causing lung injury and acute respiratory distress syndrome or ARDS. In the 1.4 million cases noted so far # liver  involvement is also seen. The cells of the bile duct contain the same receptors as the ones present in lung by which the virus causes lung damage. Theoretically, it was expected to cause damage by the same mechanism – ACE2 receptors. However, practically we have not noted significant liver injury. No case of #LiverFailure caused by the virus per se is noted. There is rise in transaminases and non-specific abnormalities are noted in # LiverFunctionTests   or # LiverProfile . Most studies have found elevation of AST and total bilirubin similar to injury caused by other non hepatotrophic viruses. Initia...

Millions of people buy new cars regularly in the United States. With so many companies regularly launching new models that continue to amaze humans, the sale of cars goes on incessantly. And buying car insurance is mandatory which in turn leads to a high sale of car insurance, nationwide. And given the demand for car insurance, you would expect the sellers and agents to have a good time by getting ample leads and converting them to sales. But nothing in this world comes easy. Does it? The agents and brokers often suffer from the lack of   genuine car insurance lead   in spite of all the demand in the market. This again has various reasons and the agents or brokers can’t be blamed. There are too many sellers in the market with multinational corporations as well with a lot of resources at their disposal. They are able to get most of the leads and convert them leaving behind very few leads for the other agents and brokers. Another reason why these agents and brokers...